Computed tomographic study of the skeletal musculature of the lower body in 45 postpolio patients
ABSTRACT Muscle computed tomography (CT) and muscle strength assessment of the pelvic girdle and leg muscles were performed in 32 postpolio patients experiencing new muscle weakness, and in 13 postpolio patients with stable neuromuscular condition. Muscles of the postpolio patients experiencing new muscle weakness showed significantly more CT scan abnormalities as compared with the stable postpolio patients. No other features discriminative of symptomatic postpolio patients were found. In individual patients, muscle CT scan evaluation is a useful adjunct to muscle strength assessment.
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Article: Post-Polio Research at AMC Amsterdam[Show abstract] [Hide abstract]
ABSTRACT: The research on post-polio syndrome in Amsterdam started in 1989 and was initiated by professor Marianne de Visser, neurologist. From that time on increasing numbers of Dutch patients with post-polio syndrome came to the AMC Amsterdam. Post-polio research has continued in Amsterdam, led by Marianne de Visser, Anita Beelen and Frans Nollet, resulting in 29 peer reviewed scientific papers up till now. PhD theses were written by Barbara Ivanyi in 1999, Frans Nollet in 2002, Herwin Horemans in 2005, Merel Brehm in 2007, and Janneke Stolwijk-Swüste in 2009. At present 4 PhD students in the Dept of Rehabilitation are doing research in the field of polio. Research focuses on clinical studies. Some results are summarized and can be categorized as: I Epidemiological and longitudinal studies II Diagnostic studies III Physiological studies IV Intervention studies V Methodological studies Epidemiological and longitudinal studies Polio victims from the last large epidemic in The Netherlands in 1956 with almost 1800 cases were studied 39 years later. In this population-based study among 260 respondents almost 60% experienced signs of new weakness, increased disabilities and handicaps and diminished health- related quality of life. The use of devices and adaptations had increased.(8,12) A cohort of 103 polio patients was followed for six years. 27 of them had stable polio and 76 post-polio syndrome.(7,14) It appeared that health-related quality of life of the patients with PPS was lower compared to the stable functioning polio individuals. Over the years physical functioning did not change much. However, it appeared that the severity of paresis at baseline was a prognostic factor for decline in physical functioning in six years. These results supported the concept of overuse, that a (slow) decline in muscle mass, as a late effect of polio, may lead to a decline in physical functioning as the reduced muscle capacity becomes less able to meet the demands of daily physical activities. In a systematic review of the literature we concluded that so far no conclusions can be drawn from the literature with regard to the functional course or prognostic factors in late-onset polio sequelae.(23) The rate of decline in muscle strength is slow, and prognostic factors have not yet been identified. Long-term follow-up studies with unselected study populations and age- matched controls are needed, with specific focus on prognostic factors. Therefore we are presently conducting the CARPA-Polio study (Comorbidity and Aging Effects in Rehabilitation Populations on Activities). The longitudinal CARPA study focuses on the effects of aging and co-morbidity on functioning over time in 3 patients groups: Polio, M Parkinson, hip and knee osteoarthritis. The CARPA-Polio cohort includes 168 polio individuals.(26) Individuals range in age between 45 and 85 years and in contrast with many other studies, co-morbidities are not excluded but its influence on the time course is studied to reflect what happens in reality with aging. At the moment the participants in the study have been followed for 5 years. Some results have been published and included in the thesis by Janneke Stolwijk-Swüste. Age and co- morbidities were found to be negatively associated with physical functioning and physical independence. The influence of these factors on the changes over time is limited.(31) More
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ABSTRACT: To investigate perceived health and its relation to residual paresis from polio, late onset neuromuscular symptoms following poliomyelitis (LSP), and sex, in a population based sample of polio survivors. 350 subjects traced from the notification records of the Dutch 1956 polio epidemic received a mailed questionnaire on residual polio paresis and new neuromuscular symptoms. Perceived health was measured using the Nottingham health profile. Respondents with new muscle weakness and new neuromuscular symptoms were considered as cases with LSP. Health problems were perceived by 151 of the 260 respondents. Respondents with residual paresis had significantly more health problems than clinically recovered respondents for the Nottingham health profile category of physical mobility. The perceived health of respondents with LSP (45.5%) was significantly worse than that of respondents without LSP for all the health profile categories. Among the respondents with LSP, health status did not differ between those with residual paresis and those who had recovered, except for physical mobility. Female respondents with LSP reported worse health status than male respondents with regard to physical mobility and social isolation. In this population based sample, health problems were frequently reported. They were mainly related to late onset neuromuscular symptoms following poliomyelitis, which were perceived by a substantial proportion of all polio survivors-not only subjects with polio residuals but also individuals who (subjectively) had recovered from polio.Journal of Neurology Neurosurgery & Psychiatry 01/2003; 73(6):695-700. DOI:10.1136/jnnp.73.6.695